Provider Demographics
NPI:1972633063
Name:FORD, JANE ZOLECKI (MHS, PT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ZOLECKI
Last Name:FORD
Suffix:
Gender:
Credentials:MHS, PT
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:ZOLECKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:570-550-0168
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:3708 FORESTVIEW RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2391
Practice Address - Country:US
Practice Address - Phone:919-786-7434
Practice Address - Fax:919-786-7437
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP4887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist